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Policy and Procedure Template Guide

Utilization of templates can streamline the policy development and review process, as well as help to ensure that no important information is omitted. The policy template should include the following elements, among others:

I. HEADER

----The header section includes: Policy title, which should be brief and descriptive. Policy number, to track updates. Policy status (i.e, in effect, since revised or obsolete). Date on which the policy was approved, reviewed - and/or revised. Area or unit that drafted the policy and to which it applies.

II. PURPOSE The purpose section summarizes the policy's objectives and explains why it is necessary to take this action.

III. DEFINITIONS The definitions section explains technical terms for the benefit of novice readers and contextualizes potentially ambiguous words.

IV. POLICY The policy section provides a historical, legal and ethical framework for the new or revised protocol and describes intended outcomes.

V. PROCEDURE

---The procedure section is designed to do the following: Outline the basic processes involved. Identify the participants and their specific responsibilities. Instruct readers in a step-by-step manner as to how the - policy is to be implemented. Refer to other guidelines, documents and other materials needed to implement the policy.

VI. RELATED POLICIES AND FORMS The related policy section cites key background information,

--including: Companion policy statements that help clarify the issues. Relevant federal and state laws, as well as accreditation - and regulatory standards. Standardized forms used to implement the policy/procedure.

VII. REVIEW The review section lists necessary reviewers ? e.g., department or unit managers, executive leadership, the medical director, governing board members, and chair of the policy and procedure review committee ? and provides a schedule for the approval process. It contains a signature block to document approval.

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Healthcare Perspective is a limited-edition publication for healthcare business owners. This series explores a range of relevant risk management concepts and offers strategies to detect and mitigate risks.

Published by CNA. For additional information, please contact CNA at 1-888-600-4776. The information, examples and suggestions presented in this material have been developed from sources believed to be reliable, but they should not be construed as legal or other professional advice. CNA accepts no responsibility for the accuracy or completeness of this material and recommends the consultation with competent legal counsel and/or other professional advisors before applying this material in any particular factual situation. This material is for illustrative purposes and is not intended to constitute a contract. Please remember that only the relevant insurance policy can provide the actual terms, coverages, amounts, conditions and exclusions for an insured. All products and services may not be available in all states and may be subject to change without notice. "CNA" is a service mark registered by CNA Financial Corporation with the United States Patent and Trademark Office. Certain CNA Financial Corporation subsidiaries use the "CNA" service mark in connection with insurance underwriting and claims activities. Copyright ? 2016 CNA. All rights reserved.

Healthcare Providers Service Organization and Nurses Service Organization are registered trade names of Affinity Insurance Services, Inc. (AR 244489); in CA & MN, AIS Affinity Insurance Agency, Inc. (CA 0795465); in OK, AIS Affinity Insurance Services Inc.; in CA, Aon Affinity Insurance Services, Inc. (0G94493), Aon Direct Insurance Administrators and Berkely Insurance Agency; and in NY, AIS Affinity Insurance Agency.

Published 2/16. Healthcare Perspective 2016-8.

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